Erlanger Tour Focuses On Vision Of New Children's Hospital; Hospital Strengths And Challenges

Thursday, February 27, 2014 - by Gail Perry
Helicopter operation
Helicopter operation
- photo by Gail Perry

Despite the struggles Erlanger has experienced, President and CEO Kevin Spiegel has a vision and plans for the future of the hospital. At a presentation made by the Erlanger Health System Foundation, he told of plans to build a world-class children’s hospital that would serve the region around Chattanooga. Officials are in the early stages of determining how they can make that happen.

T.C. Thompson, who was mayor of Chattanooga at the time, led the fundraising and motivated the community for building a hospital devoted to the care of children.

It was started in 1927 and finished in 1929 as an independent hospital that became affiliated with Erlanger in 1953. The facility moved to the present location adjoining Erlanger Hospital in 1975.

According to Dr. Alan Kohrt, the average age-span of a children’s hospital is 45 years, and the current building now needs to be replaced. The surgical units, emergency department and one floor have been re-done since it was originally built, but the rooms still do not meet today’s codes and are grandfathered in. One of the biggest problems is that the rooms were built to hold cribs and are small which makes it difficult for parents to sleep with their children.

A new facility would serve not only Chattanooga but the entire region. This area is the second in the country for asthma, and 38 percent of children are obese or overweight. The infant mortality rate is higher than many Third-World countries and there are mental care needs, said Dr. Kohrt. All these childhood problems can lead to failure in school that causes the inability to get good jobs or unhealthy workers. Erlanger is in the process of figuring out how to deliver care to the entire region to make children healthier.

Erlanger is the area’s number one trauma center. The emergency department sees 40,000 patients each year and has 33 beds, including four for trauma. Patients are seen according to severity in the ED and the time in-to-out averages just 90 minutes. The ED is 100 percent computerized within that department and is in the process of integrating its system with that of the rest of the hospital, which will provide information once an ED patient has been admitted. The hospital also offers after-hours urgent care in order to encourage people to use that service versus the emergency room.

To aid in trauma care, Life Force makes available air transport via four helicopters that are strategically positioned around the region. One is stationed in Calhoun, another in Sparta, the third in McCaysville, Ga. The hangar where the fourth helicopter is kept is on the roof of the hospital building, along with a state-of-the-art communications center. This control room is equipped with GPS equipment to pinpoint the location of each helicopter and the exact timing to the next location. Flying at a cruising speed of 140 mph a patient can be transported to the hospital quickly, but once a helicopter arrives at the destination and while in transit, this service “takes the hospital to the field.”

When Life Force was started in 1988, Erlanger owned the equipment. Each helicopter has a cost of $6 million. The helicopters, equipment and controls are now owned by Med-Trans, and are run by its employees. The nurses and medics on them are still employees of the hospital.

Stroke treatment is a specialty at Erlanger. It is an exciting time to be involved with this field of medicine, said Dr. Blaise Baxter, since the tools available to treat this condition are relatively new. The equipment to remove clots from major vessels, referred to as “the mercy device,” has only been available since 2005-2006 and is continuously being improved. This is a much needed service since the Southeastern states are considered to be “the stroke belt.” The incidence of stroke in Chattanooga is 300 percent above the average in the U.S., believed to be caused by diet, high blood pressure, diabetes, smoking, and genetic pre-disposition. Doctors here are seeing more young people in their 20s and 30s, now being admitted for stroke.

The hospital has $2 million-$3 million worth of high-tech imaging equipment to detect the location of obstructions. This machinery allows surgeons to view a screen while guiding tools for opening vessels. This expedites the process since blood flow must be restored in eight or less hours to lessen permanent damage.

Mr. Spiegel said that recently Erlanger made number 10 on the list of the most cost effective hospitals in the country, which he is proud of. But, “every day we don’t expand Medicaid is a problem” he said because Erlanger provides $90 million in uncompensated care each year. That amount is the actual cost to the hospital.

The facility receives no money from the state to help defray these expenses. Federal money in the amount of $70 million does come to Tennessee from a supplemental hospital payment pool.  That money is now transferred to hospitals in Memphis and Nashville, none of it is awarded to Erlanger despite meeting the two requirements. The facility must be a government hospital and must provide uncompensated care. Mr. Spiegel is currently in talks with Governor Bill Haslam about sharing that pool of money.

The Erlanger Foundation seeks to raise funds for advancing medical excellence at the hospital. Officials want the community to realize the many important and irreplaceable roles that this hospital provides. The foundation is now trying to create a culture of philanthropy to further goals including building the new children’s hospital. The cost of this project was compared to building four new Tennessee Aquariums. It is recognized that much support will be needed from the community for this new vision to be executed.

Stroke treatment area
Stroke treatment area
- Photo2 by Gail Perry

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